RESUMEN
The aim of this study was to evaluate the contribution of cone-beam computed tomography (CBCT) in the decision of surgical management for bone lesions of the maxillofacial region. It is a retrospective cross-sectional observational study that includes a sample of panoramic radiography (PR) and CBCT from patients with some type of bone lesion in the maxillofacial region. PR and CBCT images were evaluated by three previously assessed examiners, specialists in oral and maxillofacial surgery. Each image was evaluated randomly, and a surgical procedure was suggested, initially in PR and then in CBCT. The obtained results were submitted to the McNemar test to evaluate the frequencies of changes in the surgical management between the first and the second evaluation in PR and CBCT, and intra-examiner and inter-examiner agreements were analyzed by the Cohen's kappa test. The level of significance was set at 5% (p < 0.05). Intra-examiner agreement increases when CBCT is used. Inter-examiner agreement was low, independently of the evaluated exam, which shows that the choice of treatment plan is examiner-dependent and not exam-dependent. CBCT increases the certainty of the professional in the evaluation of the bone lesions of the maxillofacial region; however, it does not change the indication of the treatment type.
Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Maxilares/diagnóstico por imagen , Traumatismos Maxilofaciales/diagnóstico por imagen , Planificación de Atención al Paciente , Cirugía Bucal/instrumentación , Cirugía Bucal/métodos , Estudios Transversales , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Procedimientos Quirúrgicos Orales/métodos , Radiografía Panorámica , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
O rabdomiosarcoma é o sarcoma de tecidos moles mais comum em crianças e adolescentes. A multimodalidade terapêutica para tumores de cabeça e pescoço, embora eficaz, pode resultar em uma variedade de complicações orais, com efeito significativo sobre o crescimento esquelético maxilomandibular e sobre o desenvolvimento dentário.Neste relato de caso, discutem-se as principais anormalidades tardias encontradas em um sobrevivente pediátrico que teve o tumor, o qual foi irradiado em estádio precoce do desenvolvimento dental. As anormalidades dentomaxilofaciais encontradas incluíram defeitos de esmalte, encurtamento radicular, microdontia, agenesia dentária, mobilidade dentária, micrognatia e assimetria facial. As morbidades cosméticas e funcionais encontradas exigem acompanhamento em longo prazo para melhorar a qualidade de vida da criança após o tratamento da lesão.
Rhabdomyosarcoma is the most common soft tissue sarcoma in children and adolescents. Multi-modality therapy for tumors in the head and neck region may result in a variety of oral complications, with a significant effect on maxillofacial skeletal growth and dental development. This article reports on major oral abnormalities in one long-term survivor of paediatric head and neck rhabdomyosarcoma who had irradiation at an early stage of their teeths development. Dentomaxillofacial abnormalities found included enamel defects, disturbance in the root development, microdontia, tooth agenesis, severe dental mobility, micrognatia and facial asymmetry. In addiction, the cosmetic and functional morbidity require follow-up over time to improve patients quality of life in survivors of oncologic treatment.